Nationwide provider of leading day-case surgery

Nationwide provider of leading day-case surgery

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CHL TERMS AND CONDITIONS

The terms and conditions of business apply to services carried out by CURIS HEALTH LTD

DEFINITIONS

1.1. 1.2. “CHL”, “Company”, “We” and “Us” here refers to Curis Health Limited and its Agents, company number 14716318.

“Patient Information” here refers to personally identifiable information referencing a natural person who wishes to engage

with CHL for services. This information may be clinical or clerical in nature and may be supplied/collected orally, in

brochures, letter form and/or electronic communication.

1.3. “Procedure” here refers to the intended medical procedure(s) to be carried out by a surgical team, under the direct care

of Consultant(s) engaged by the Patient, who hold(s) a ‘practicing privileges agreement’ or Surgeon/Anaesthetist contract

or is in some other way permitted to carry out medical procedural activities at CHL premises. Patients attending external

facilities will contract with that facility for the in-Patient episode which would usually include a Consultant Surgeon and

Consultant Anaesthetist.

1.4. “Consultant Surgeon”, “Surgeon”, “Admitting Practitioner”, “Consultant Anaesthetist” and “Anaesthetist” here means the

registered medical professional(s) ultimately responsible for patient care and registered with the General Medical Council.

1.5. “Patient” here means any person who has entered into a contract with CHL for the services advertised, or any person who

engages with CHL with the intention of entering into a contract for services with CHL, and whom CHL have accepted.

1.6 “Non-surgical aspects of a procedure” here means the services provided by CHL, namely the provision of the premises;

the theatre and the preoperative assessment and with CHL for the post-operative nursing care. It does not include the pre-

operative and post-operative consultation and/or advice and/ or treatments (which include decisions on medication and

discharge of the Patient), which remain with the appropriate Admitting Practitioner. Patients attending external facilities will

contract with that facility for the in-patient episode.

1.7. “Pre-booking” means a booking and payment made prior to consultation with a Surgeon. A pre-booking is not a guarantee

of patient suitability for a specific surgical plan and is purely a hold placed to secure surgical diary space.

1.8. “Surgical cover” means the post-operative care and support provided by CHL and the Admitting Practitioner included within

the cost of the procedure.

1.9. “Cost” is total price for services as detailed on the quotation.

1.10. “Consultation” here means:

1.10.(1) A meeting between the Patient and the Surgeon, at which the Patient’s condition, expectations and motivations are

reviewed, a treatment plan is devised to address condition, and suitability for that procedure is considered.

1.10.(2) A meeting between the Patient and the Surgeon to review the outcome of a surgical intervention, with or without the

provision of further treatment.

1.10.(3) Appointments with Patient Care Co-ordinators (PCC) and/or any members of CHL staff are intended to support the

intended surgical journey by information gathering and supporting the Patient to make an informed choice about the

procedure. The PCC and/or member of staff is unlikely to be a doctor and any advice they give should, in any event, be

regarded as purely of a general non-medical nature. For avoidance of doubt, these appointments are NOT considered as

a consultation.

1.11. “Premises” means any hospital, clinic, or other building, or part thereof, under the ownership, occupation, or management

of CHL.

1.12. 1.13. “External facilities” are those not owned, under the control of, or management by CHL.

“Further surgery” refers to additional surgical interventions performed following the original operation, which is either

included in the original costs paid, or when additional fees are charged.

1.14. “Previously unknown medical condition(s)” refers to a condition, illness or ailment that was either not apparent or

diagnosed prior to the patient’s first consultation with CHL. This would not include conditions that the patient was aware of

but was awaiting a formal diagnosis or specialist review.

1.15. “Temporary medical unsuitability”- A listed “active” medical condition (mental or physical) that currently prevents the

patient from meeting CHL’s medical suitability criteria to proceed with surgery. The active medical condition is considered

temporary in nature when it is expected or has the possibility to improve or resolve with treatment or recovery. Pregnancy,

anxiety conditions and depressive episodes would fall into this category. To ensure fairness, any instances of temporary

medical unsuitability will be subject to clinical review by CHL throughout its “active” status.

1.16. “Holding month” refers to a natural month in the calendar (such as January) which the patient confirms they wish to hold

clinical space within, for the purpose of undergoing surgery with CHL.

This may also be referred to as a “Holding date” in correspondence with CHL, and is here taken to mean one and the

same.

2. OBLIGATIONS AND WARRANTIES

2.1. CHL warrants that before inviting a Surgeon or Anaesthetist to receive practicing privileges rights or a Surgeon’s/

Anaesthetist’s contract permitting the said person to practice at CHL premises (and before re-issuing these intermittently

thereafter), CHL confirms that the person is registered with the General Medical Council, will undertake relevant due

diligence checks on background and surgical fitness to practice, and ensures that CHL has seen a copy of a private

practice indemnity insurance cover certificate which is current at the date of granting practicing privileges rights, or a

contract, or other such agreement which permits him/her to practice such procedures. CHL does not usually obtain copies

of the whole of the private practice medical indemnity insurance policy document and nor does it make any warranties

in respect of the content of the same, save as set out above. Patients attending external facilities should ensure that the

facility they are attending holds this documentation in respect of any practitioner who may attend to the Patient during the

in-patient episode. CHL will display or make available GMC numbers of all Admitting Practitioners within their facilities.

2.2. All surgeons, as self-employed contractors, are themselves responsible for maintaining their revalidation and registration

with the General Medical Council, keeping their surgical logbook updated, and maintaining full private practice medical

indemnity insurance. It is recommended that the Patient independently checks the most up to date position with regards

to the practitioner’s registration with the General Medical Council and his/her private practice medical indemnity insurance

position before undergoing any procedure. CHL will make available clinician profiles to assist prospective Patients in

making a choice of Surgeon based on their areas of clinical interest and experience – Patients are responsible for choosing

their own Surgeon. Surgeons and Anaesthetists which CHL may from time to time introduce to patients are self-employed

and, as such always make their own clinical decisions and are responsible for the outcome of surgery and the surgical

aspects of the procedure.

2.3. Surgeon and Anaesthetist fees are included in the quoted price and CHL acts as their agents in the collection of any

monies falling due. The Surgeon, Anaesthetist and the Hospital may invoice patients separately, but the total will not be

more than shown on the quotation. Surgeon fees may be applied or may vary where further surgery is required.

2.4. The Patient warrants no cause of action or vicarious liability will accrue against CHL for any surgical aspect of the

procedure carried out by the Surgeon and/or Anaesthetists.

2.5. The Patient warrants that they will read the patient information provided to appraise themselves of the range of possible

outcomes, risks and benefits of any proposed procedure(s).

2.6. CHL will provide all immediate post-operative medication required relevant to the procedure (i.e. antibiotics and painkillers)

as prescribed by the relevant Surgeon or a Doctor; where the medicine is not included in CHL’s formulary (or the Patient

has sensitivities requiring non-standard medication), a private prescription will be provided to the Patient and the fee for this

prescription is the responsibility of the Patient. Patients attending external facilities will receive post-operative medication

directly from the external facility. This medication does not include any medication required after the first 5 days post op-

surgery unless this is a prescription medicine, required and prescribed by the medical practitioner. It may also not include

specialist medication required, or medicine needed if the Patient has not adhered to post-operative instructions.

3. PATIENT’S OBLIGATIONS

3.1. This contract is conditional upon the acceptance of the Patient by the Surgeon and/or Anaesthetist based upon information

given by the Patient during the consultation, and collection of further relevant medical information provided by other

Healthcare Providers. The decision to carry out any surgical intervention shall be at the discretion of the Surgeon, the

Anaesthetist and CHL.

3.2. The patient warrants that it is their responsibility to schedule post-operative review appointments with their surgeon at

recommended intervals.

3.3. The Patient agrees to comply with all post-operative instructions – including attending for the requisite number of post-

operative care appointments and abstaining from activity that could reasonably be known to prejudice the surgical

outcome.

3.4. The Patient agrees to inform CHL if they have concerns with their care or clinical outcomes at any stage of their journey

and offer CHL an opportunity to review, investigate and offer a resolution via the complaints process before publicising

any information that could reasonably be known to bring the Company or the Surgeon into disrepute in a public domain

(websites, personal social media accounts, review sites, general media and instant messaging). This does not include

raising any concerns to regulatory bodies.

3.5. The Company will endeavour to provide appointments at the nearest geographical CHL location to the Patient. Where this

is not possible or appropriate (due to care required), the Patient agrees to attend appointments at an alternative CHL clinic

or hospital.

3.6. The Patient accepts that any failure to comply with section 3.3 above, including attempts at self-care (that have not been

accepted as part of the care plan), or choosing to manage routine aftercare with an alternate provider could prejudice the

surgical outcome and may result in the removal of the 12-month surgical cover provided by CHL. (Aside from aftercare

required to bring the episode of care to a safe end.) This does not apply to suitable emergency care sought out of hours,

or at the suggestion of CHL or the Surgeon.

3.7. The Patient accepts that clinical staff may not be available 24/7 therefore calls and appointments will be offered subject to

staff and clinic availability.

3.8. The Patient understands that the Company may decline to proceed with surgery if a Patient is not prepared to provide

medical information to allow an assessment of clinical risk to be created. This includes (but is not limited to) GP summary,

specialist letters, investigations, results and supporting letters, and presenting for psychological assessments if requested.

3.9. The Patient understands that if they wish to change their surgery in any way (i.e. alter implant size or add additional

surgery) that they must return to see their Surgeon and be consulted for these changes before their procedure date, normal

terms and conditions apply, see section 5.

3.10. 3.11. The Patient has the choice to waive their right to a 14-day clinical cooling off period.

The Patient has the right to self-discharge from hospital against clinical advice. If this is to occur, a disclaimer must be

signed, accepting all risks and consequences.

3.12. 3.13. The Patient acknowledges that their PCC is not a doctor or surgeon.

Any advice that the PCC may give is purely of a general non-medical nature. If the Patient has any queries, then these

should be raised at consultation with the Surgeon, and/or Anaesthetist or other suitably qualified persons.

3.14. The Patient agrees to provide the Surgeon, Anaesthetist and clinical staff of the hospital with a health history that is honest,

accurate, reliable and complete. The Patient understands that knowingly withholding any medical information that could

be detrimental to their health and safety may result in cancellation of the procedure with no refund. The Patient agrees that

if any change occurs in his or her medical history or status to inform CHL and the Surgeon and the Anaesthetist without

delay and to keep CHL, the Surgeon, and the Anaesthetist informed. Patients are required to provide a GP Summary

covering a minimum of the previous five years before their pre-operative assessment/appointment. Failure to provide this

documentation may result in the pre-operative assessment being postponed and surgery being unable to proceed, this

may include applicable fees as per section 5 in the T&Cs.

3.15. Treatment will only be given where monies falling due have been received at least 30 days prior to surgery (or as soon as

possible for surgery booked less than 30 days in advance, but always prior to surgery).

3.16. 3.17. The minimum age for any consultation or surgical procedure is 18 years of age.

The Patient acknowledges that any consent they are signing is a confirmation that they understand the surgical

intervention proposed, and agree that it should proceed. Consent may be withdrawn at any point prior to anaesthesia,

however, should the patient be unsure of any aspect covered in the consent form, they should ask clarifying questions and

be assured prior to proceeding with surgery.

4.3. 4.4. 4.5. 4.6. The terms and conditions of business apply to services carried out by CURIS HEALTH LTD

3.18. The Patient agrees that the Company is not responsible for costs associated with any treatment that CHL or the operating

Surgeon recommend but do not provide, such as ultrasound scans, or any other payable service that is recommended be

provided externally.

3.19. 4.1. The patient understands that CHL will not be vicariously liable for any treatment not provided by the Company.

4. GENERAL OBLIGATIONS

CHL reserves the right to alter the Patient’s admission date and/or outpatient appointments although such changes will be

avoided wherever possible. The Patient agrees that no consequential loss will be payable for the short notice cancellation

on any procedure/ appointment (including reimbursement for travel, tests, hotels).

4.2. The Patient agrees that in signing this set of terms and conditions and any pre-operative medical notes that he/she has

understood the terms and has been given an opportunity to seek explanation. The pre-operative medical notes are

designed to ensure there is a contemporaneous record that both the Patient and Surgeon are fully aligned as to the

procedure that has been planned for before the operation and that the potential risks and benefits are understood. Patients

must sign this form before surgery commences.

The Patient accepts that CHL’s liability for breach of contract is any way limited to the operation costs. The Patient and the

Surgeon will be required to sign a medical consent form at the hospital prior to surgery.

The company reserves the right to cancel or postpone procedures. This decision must be a reasonable one and in the best

interest of the Patient; in the event of late cancellations or movements, the company accepts no liability for any financial

loss to the Patient and no reimbursements will be given.

Patients agree that dates offered within a holding month are filled in the order bookings are mutually confirmed. Patients

are expected to be available for surgery at any date during the holding month. Surgery dates will be released within a

reasonable timeframe.

CHL operates a zero-tolerance policy towards abusive, threatening, violent, discriminatory, intimidating, or otherwise

unacceptable behaviour towards staff, clinicians, contractors, or other patients. Where, in CHL’s reasonable opinion, such

behaviour occurs, we reserve the right to suspend or immediately terminate the provision of services and cease providing

care, subject to legal, regulatory, and professional obligations, including making appropriate arrangements for continuity of

care where required.

5. RESCHEDULING

5.1. Rescheduling here refers to a cancellation of a planned surgical date/holding month, with a corresponding booking

commitment made for a later date instead. If the Patient needs to reschedule surgery, the following fees may apply to

offset against administration and losses incurred:

5.2. 5.3. 5.4. 5.5. 5.6. 28 days or more notice: £75

27 to 14 days’ notice: £250

13 to 6 days’ notice: £500

5 days’ or less notice: £1000

Patients must notify the company immediately if they are experiencing any symptoms of illness 5 days or less prior to

surgery. CHL reserve the right to assess the Patient’s fitness for surgery and to reschedule any procedure on the grounds

of temporary medical unsuitability following the disclosure or discovery of medical conditions/factors within 5 days of

surgery, where proceeding with surgery on the scheduled date would likely increase risk to the Patient. In these instances,

a fee of £1000 may be applied. Temporary medical unsuitability would include (but is not limited to) a positive pregnancy

or nicotine test, discovery/disclosure of cold/flu symptoms and a change in Body Mass Index (outside of acceptable safety

thresholds). If the Patient decides to cancel rather than reschedule, please refer to section 7 of the terms and conditions.

5.7. If upon arrival on the day of the procedure the Patient presents with symptoms of a potentially communicable illness (e.g.

cold, cough, fever), the company reserves the right to reschedule the surgery for the safety of the Patient and medical team

and retain all monies paid for that procedure.

This policy does not affect the 5-day period of reflection.

5.8. If a patient reschedules their surgery and books a new date which is later cancelled, CHL may determine the original

surgery date as cancelled with cancellation fees applicable from the original date of surgery. Fees payable will be in line

with sections 6.2-6.5.

6. CANCELLATIONS

6.1. 6.2. 6.3. 6.4. 6.5. 7.1. Cancellation here refers to a cancellation of a planned surgical date/holding month.

Cancellations made over 2 weeks prior to date of surgery/holding month.

Cancellations made 8-14 days prior to date of surgery/holding month – 50% of the total cost.

Cancellations made 7 – 3 days prior to and including date of surgery/holding month – 75% of the total cost.

Cancellations made 3 days or less – full cost of surgery retained.

7. CANCELLATIONS FOR MEDICAL REASONS

If after reasonable consideration the indicated medical condition/medical factors prevent safe rescheduling of the

procedure, then refund of the monies paid will be given in full to the Patient.

7.2. Cancellations due to pre-existing medical conditions which were known by the Patient but undisclosed prior to booking the

procedure will be refunded in line with section 6.2 – 6.5 of these terms and conditions.

7.3. If the procedure is abandoned intra-operatively due to unforeseen medical conditions/factors, CHL will retain sufficient

monies to cover the costs incurred by the Company as reasonably deemed fit and in accordance with these terms and

conditions.

7.4. “Pre-booked” surgeries may be cancelled at any time prior to consultation and will receive a full refund including the

deposit. Cancellations made after the 5-day period of reflection following consultation will be refunded in line with section

6 above.

7.5. Patients will receive a nicotine and pregnancy test on the day of surgery, should either test be positive, a fee may be

charged of up to £1,000 to cover costs of lost surgical space.

8. COMPLAINTS & RE-ADMISSION

8.1. The complaints procedure is available on request from the PCC or via CHL’s website. If patients have a complaint regarding

any aspect of care, outcome or treatment, it is recommended that this is discussed with the PCC in the first instance. The

PCC may seek intervention from the Registered Manager or Patient Care Manager to help resolve complaints locally. If

no resolution can be reached, the formal complaints process can be initiated. Resolutions reached during the complaints

process may be subject to a full and final settlement agreement.

Complaints follow a 3-stage process, 2 stages internal and final stage Panel Review. Each stage will receive

acknowledgment within 3 working days and a response within 20 working days of the date of your formal complaint or

response (unless extended in writing). Patients have 3 months from the date of the company’s formal response to escalate

the complaint. We may consider late escalation requests where there is a reasonable explanation for the delay. If at any

stage legal advice is sought by the Patient, CHL reserves the right to pause the complaints process to seek their own

legal advice. This does not affect the patient’s rights and upon CHL obtaining legal advice, the complaints process will

resume unless legally advised against. During this time, updates will be provided on response time frames as per polices.

A complaint must be initiated no longer than 6 months from the end of surgical cover or no longer than 6 months from the

date the issue presented and was raised with the company.

The initial aftercare period will include standard postsurgical review appointments within the term specified on the personal

quotation. CHL reserves the right to change the aftercare policy from time to time. In case of any doubt, the aftercare policy

in force at the time of booking will be applied. CHL reserve the right to remove surgical cover if the Patient has failed to

follow the terms set to them, but (where safe and appropriate to do so) will continue offering aftercare to safely bring the

episode of care to a clinical end point.

Where safe and appropriate to do so CHL reserves the right to pause all further surgery, pre-operative appointments,

surgical interventions and surgical cover should the Patient decide to enter the formal complaints process or seek legal

advice/ intervention. This does not affect patient’s rights, it is designed to protect both parties while an agreement is

reached; once resolved, surgical cover will be resumed.

Readmissions / Further surgery section

Readmission – following surgeon review for up to 12 months after a surgical procedure, if both the Patient and Surgeon

agree that further surgery (as part of the original procedure) is necessary to assist in achieving an improvement to the

outcome, CHL and the Surgeon will consider contributing to the surgical and hospital costs. If, however, your Surgeon

decides that the results of the surgical procedure are acceptable within the normal limitations and expectations set of

surgery, then further surgery may incur the full fee. CHL will assess separately the circumstances of each patient in

determining the basis on which further surgery may be provided. CHL will make the ultimate decision on further surgery

and the Company’s decision is final. Further surgical procedures do not automatically provide the same aftercare time as

the original procedure, please check with CHL on the period of cover that will be applicable when planning this. Further

surgery may be also provided as part of a compromise agreement, there is a formal process and approval for further

surgery and could take up to 8 weeks; if further surgery is approved and is free of charge, the company may not provide

any garments and may not accept any financial losses to the Patient, which includes travel, tests and accommodation

costs; A nominal theatre reservation fee will be payable to secure a further surgery date of £500, normal terms and

conditions will apply to further surgery and rescheduling. (See 5.0).

If further surgery is required and approved during the period of surgical cover, the Company may ask the Patient to wait a

period of time whilst their body is recovering – surgical cover is not affected by this requirement to undertake a “watchful

wait” period, regardless of whether the wait period takes the Patient outside of the normal 12 months of cover.

If the Patient has further surgery approved, but wishes to modify this, or add another procedure whilst they are under

anaesthetic; the Company can try to accommodate this based on clinical requirements and safety and costs may be added

where required.

If the Patient fails to attend review appointments or follow advice and guidance given, or where the results of the surgery

originally provided have been affected by changes in lifestyle, weight changes, illness or the natural ageing process, CHL

will not commit to providing further surgery at a reduced cost.

CHL agrees that all matters relating to the Patient’s treatment will be kept as confidential save where CHL are required to

disclose such material to relevant members of medical staff at CHL or other relevant providers and regulatory bodies.

The company adheres to UK data protection legislation, only sharing data where necessary. If a Patient decides to disclose

their personal or medical details on a public forum, such as social media, general media, websites or instant messaging

platforms; the company reserves the right to respond or comment on that disclosure, so long as no new unshared

information is disclosed. If a Patient chooses to disclose information in a public forum and the Company believes this to

be untrue or defamatory; the company reserves the right to respond to the information or contact the Patient privately to

discuss the matter with a view to having any untruthful or defamatory content removed. This action may also invalidate any

surgical cover. Defamation is an offence under the Defamation Act 2013 and the company may pursue resolution via the

appropriate channels if necessary. If the Patient fails to adhere to section 3.4 of these terms in allowing CHL to address

any concerns prior to publicising any information in a public domain, this may invalidate surgical cover.

The Patient confirms their consent to the disclosure of personal information by CHL to Surgeons, Anaesthetist’s and

clinicians involved with the provision of their care and administration of their booking.

If required, your PCC will provide you with the policy on access to medical records.

As a Joint Data Controller, throughout your treatment journey your Surgeon may take clinical photographs that they hold

within their own clinical records. Whilst CHL maintain copies of all clinical records supplied (and requests that Surgeons

provide copies of all clinical photography to CHL), any records maintained solely with the Surgeon (including clinical

photography) would need to be requested from the Surgeon in the event of a Data Subject Access Request, and CHL do

not take any responsibility for the storage or retention of these records.

10. JURISDICTION

10.1. The laws of United Kingdom shall apply to this contract and the courts of United Kingdom shall have exclusive jurisdiction